The Health Education Center at Lankenau Hospital 100 Lancaster Avenue, Wynnewood, PA July 20-24, 2009 Teach Epidemiology Professional Development Workshop Day 5

2 Teach Epidemiology

3 Time Check 9:15 AM

4 If …, then ….

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Backpacks and Back Pain Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain Is there an association between the hypothesized cause and the disease?

Ache! Testing Hypotheses Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

Acne No Acne Total b d a c AcneMed No AcneMed 100 Trial Carrying heavy backpacks causes back pain. Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

Back Pain No Back Pain Total b d a c Heavy Backpacks No Heavy Backpacks Observational Study Carrying heavy backpacks causes back pain. Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

Exposure Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

Exposure Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

Exposure Check one. Heavy Backpack No Heavy Backpack Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

Outcome Any memorable pain in the past two weeks. What is back pain? Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

Outcome Check one. Back Pain No Back Pain Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

2 x 2 Table Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

Epi Talk Observational Studies Were you involved in assigning exposures? Did you observe what others had done to themselves? Did you record, classify, count and statistically analyze the results? Epidemiologic studies in which the investigator is not involved in the subjects' exposures other than to record, classify, count, and statistically analyze results. Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

Carrying Heavy Backpacks Causes Back Pain. We are all carrying out “natural experiments” on ourselves each day of our lives, as we decide what to do, where to go, and to what to expose ourselves. Detectives in the Classroom - Investigation 2-4: Backpacks and Back Pain

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Investigation 2-5 Observational Studies Part 1

Observational Study Selecting a HypothesisStep 1 Planning the StudySteps 2-7 Collecting DataSteps 8-13 Analyzing DataSteps Planning the PresentationStep 18 Detectives in the Classroom - Investigation 2-5: Observational Studies

Epi Log Worksheet Detectives in the Classroom - Investigation 2-5: Observational Studies 1 Handout

CDC Planning the Study Define the exposure. Create a question to gather data about the exposure. Create a question to gather data about the outcome. Create an informed consent statement for participation in the observational study. Label 2 x 2 Table Sheet. Step 2: Step 3: Step 4: Step 5: Step 7: Step 6: Define the outcome in the hypothesis. 2-7 Detectives in the Classroom - Investigation 2-5: Observational Studies

Review Epi Talk Voluntary consent given by a person for participation in a study. Informed Consent Participants must know and understand the study, give consent without coercion, and know that they can withdraw at any time. Detectives in the Classroom - Investigation 2-5: Observational Studies

Collecting Data Read informed consent statement and remind class of right not to participate. Have class label 2 x 2 Table Sheets. Review what cells students “fit” into based on answers to exposure and outcome questions. Instruct class to voluntarily and anonymously place a check in the cell that identifies their exposure and outcome for the hypothesis being tested. Step 8: Step 9: Step 10: Step 11: Step 12: CDC Review exposure and outcome questions. Detectives in the Classroom - Investigation 2-5: Observational Studies

Collecting Data Detectives in the Classroom - Investigation 2-5: Observational Studies Handout

Collecting Data Read informed consent statement and remind class of right not to participate. Have class label 2x2 Table Sheets. Review what cells students “fit” into based on answers to exposure and outcome questions. Instruct class to voluntarily and anonymously place a check in the cell that identifies their exposure and outcome for the hypothesis being tested. Step 8: Step 9: Step 10: Step 11: Step 12: CDC Review exposure and outcome questions. Detectives in the Classroom - Investigation 2-5: Observational Studies

Analyzing Data Calculate the risks of the outcome for the exposed and unexposed groups as fractions and percents. Calculate the relative risk. Complete the statement. CDC Explain whether or not the data support the hypothesis. Step 13: Step 14: Step 15: Step 16: Step 17: Sort 2 x 2 Table Sheets and complete the 2 x 2 table that was labeled in step 6. Detectives in the Classroom - Investigation 2-5: Observational Studies

IMRAD IMRADIMRAD ========== Introduction Methods Results and Discussion Presentation Planning Detectives in the Classroom - Investigation 2-5: Observational Studies

Epi Talk IMRAD Epi Talk Format usually followed when epidemiological studies are published in medical journals. Introduction: Why the authors decided to do the study, Methods: How authors did the study, Results: What the authors found, and Discussion: What the results mean. Detectives in the Classroom - Investigation 2-5: Observational Studies

IMRAD IMRADIMRAD ========== Introduction Methods Results and Discussion Step 18: Presentation Planning 18 Detectives in the Classroom - Investigation 2-5: Observational Studies

Epi Teams Detectives in the Classroom - Investigation 2-5: Observational Studies

Presentation Rubric CriteriaGot ItGetting ItWill Get It Soon Participation All participateMost participateSome participate Use of Epi Talk All are appropriate and accurate Most are appropriate and accurate Some are appropriate and accurate Data Collection Methods All are thorough and accurate Most are accurateSome are accurate Risks, Relative Risk, and Inference All are identified and accurate Most are identified and accurate Some are identified and accurate IMRAD All are presented and accurate Most are presented and accurate Some are presented and accurate Detectives in the Classroom - Investigation 2-5: Observational Studies

Observational Study Detectives in the Classroom - Investigation 2-5: Observational Studies

Observational Study Detectives in the Classroom - Investigation 2-5: Observational Studies

Observational Study Detectives in the Classroom - Investigation 2-5: Observational Studies

Acne Auto injuries Bad mood Cavities Cell phones Class disruption Chewing gum Colds Drinking soda Eating breakfast Eating candy Eating high fat food Eating school cafeteria food Exercise Foul language Getting a good night’s sleep Good quiz scores Good grades Having a quiet place to study Head aches Selecting a Hypothesis Improves performance Indigestion Lack of regular exercise Listening to music while studying Listening to rap music Multi-vitamins Nightmares Overweight Poor grades Poor quiz scores Practicing a sport Seat belts Skipping breakfast Studying Too much talking on the telephone Violent behavior Watching the evening news on TV Watching too much TV Watching violent movies Wearing hats Detectives in the Classroom - Investigation 2-5: Observational Studies

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Think Like an Epidemiologist Challenge New Jersey Science Olympiad High School Finals March 17, 2009

Test the hypothesis: People who watch more TV eat more junk food. Handout

Getting Ready 1

Asking Questions / Gathering Data 2

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2

Analyzing Data / Testing Hypotheses 3

3

Reporting Out 4

4 Handouts

Authentic Assessment Teach Epidemiology Epi – Grades 6-12 Are realistic; simulate the way a person’s understanding is tested in the real world Require judgment and innovation to address an unstructured problem, rather than following a set routine Ask students to “do” the subject rather than simply recall what was taught Replicate the context in which a person would be tested at work, in the community, or at home Are messy and murky Require a repertoire of knowledge and skill to be used efficiently and effectively Allow opportunities for rehearsal, practice, consultation, feedback, and refinement

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51 Teach Epidemiology

52 Teach Epidemiology

53 Teach Epidemiology

54 National Research Council, Learning and Understanding Teach Epidemiology Enduring Epidemiological Understandings Knowledge that “… is connected and organized, and … ‘conditionalized’ to specify the context in which it is applicable.”

55 Teach Epidemiology Enduring Epidemiological Understandings Ken Bain, What the Best College Teachers Do “… they can distinguish between foundational concepts and elaborations or illustrations of those ideas.”

56 Learners “… presented with vast amounts of content knowledge that is not organized into meaningful patterns are likely to forget what they have learned and to be unable to apply the knowledge to new problems or unfamiliar contexts.” National Research Council, Learning and Understanding Teach Epidemiology Enduring Epidemiological Understandings

57 Teach Epidemiology Enduring Epidemiological Understandings To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding other things like it that one may encounter. Jerome Bruner, The Process of Education, 1960 will

58 Multi-State Outbreak of E. coli O157:H7 Infections from Spinach Teach Epidemiology Enduring Epidemiological Understandings To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding other things like it that one may encounter. Jerome Bruner, The Process of Education, 1960 will

59 Salmonella Outbreak Linked to Raw Tomatoes Teach Epidemiology Enduring Epidemiological Understandings To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding other things like it that one may encounter. Jerome Bruner, The Process of Education, 1960 will

60 Teach Epidemiology Enduring Epidemiological Understandings To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding other things like it that one may encounter. Jerome Bruner, The Process of Education, 1960 will

Teach Epidemiology In the News During the coming school year, participate in an online Teach Epidemiology In the News - Social Network and teach epidemiology.

62 Depressed Teens at Higher Risk for Pregnancy and STDs

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In the News Article Selection Criteria Popular press article and scholarly article Potential to check other sources for information Non-controversial topic Age group / reading level appropriate Consider potential for inclusion of other disciplines Includes data and visuals Topical, but not too great a potential to become dated Background Identify standards that apply Teach Epidemiology Teach Epidemiology In the News - Social Network

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66 Time Check 10:45 AM

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68 Teach Epidemiology

69 Time Check 11:00 AM

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71 Teach Epidemiology

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73 Hypothesis Total RiskRelative Risk a b c d or % % ExposureOutcome ? Turned Up Together Healthy People - E E DZ Teach Epidemiology Enduring Epidemiological Understandings

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75 Workshop Goal Teach Epidemiology To increase the frequency with which epidemiology is taught to students in grades 6-12

76 Teach Epidemiology Workshop Goal To increase the frequency with which epidemiology is taught to students in grades 6-12

77 Graduate School Middle School High School Teach Epidemiology Workshop Goal

Teach Epidemiology Innovation … an idea, practice or object that is perceived as new by an individual or other unit of adoption. Everett M. Rogers, Diffusion of Innovations Workshop Goal

Diffusion The process by which an innovation is communicated through certain channels over time among the members of a social system (with the aim being to maximize the exposure and reach of innovations, strategies, or programs.) Everett M. Rogers, Diffusion of Innovations Teach Epidemiology Workshop Goal

Empowers students to be scientifically literate participants in the democratic decision-making process concerning public health policy. Empowers students to make more informed personal health-related decisions. Increases students’ media literacy and their understanding of public health messages. Increases students’ understanding of the basis for determining risk. Improves students’ mathematical and scientific literacy. Expands students’ understanding of scientific methods and develops their critical thinking skills. Provides students with another mechanism for exploring important, real world questions about their health and the health of others. Introduces students to an array of career paths related to the public’s health. Top 8 Reasons to Teach / Learn about Epidemiology Teach Epidemiology

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82 Explore Public Health Career Paths Teach Epidemiology What do you mean - Teach Epidemiology?

83 Leverage the Young Epidemiology Scholars Competition Teach Epidemiology What do you mean - Teach Epidemiology?

84 Leverage the Science Olympiad Competition Teach Epidemiology What do you mean - Teach Epidemiology?

85 Show and Discuss Is Epidemiology in Your Future? Teach Epidemiology What do you mean - Teach Epidemiology?

86 Infuse Epidemiology into Existing Lesson about Something Else Teach Epidemiology What do you mean - Teach Epidemiology?

87 Teaching Existing Epidemiology Lessons Teach Epidemiology What do you mean - Teach Epidemiology?

88 Teaching Existing Epidemiology Lessons Teach Epidemiology What do you mean - Teach Epidemiology?

89 Teaching Existing Epidemiology Lessons Teach Epidemiology What do you mean - Teach Epidemiology?

90 Teaching Existing Epidemiology Lessons Teach Epidemiology What do you mean - Teach Epidemiology?

91 Teaching Existing Epidemiology Lessons Teach Epidemiology What do you mean - Teach Epidemiology?

92 Teaching Existing Epidemiology Lessons Teach Epidemiology What do you mean - Teach Epidemiology?

93 Teaching Existing Epidemiology Lessons Teach Epidemiology What do you mean - Teach Epidemiology?

94 Teaching Existing Epidemiology Lessons Teach Epidemiology What do you mean - Teach Epidemiology?

95 Teaching Existing Epidemiology Lessons Teach Epidemiology What do you mean - Teach Epidemiology?

96 View a News Item from an Epidemiologic Perspective Teach Epidemiology What do you mean - Teach Epidemiology?

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Post-Workshop Assessment Teach Epidemiology

Workshop Process Evaluation Teach Epidemiology

100 Time Check Noon

Teach Epidemiology Professional Development Workshop Day 5 Thank You

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